Blood Work

I’ve been using my lifesaving bio-identical hormone cream every night for 10 years now. Lately it feels a little off and, since I’ve never had any blood work done to see if the dosage was just right, I thought, "Why not have it done in Costa Rica?" You know, where’s it’s cheap.

My doctora [doke-TORE-ah, female doctor] told me to have the tests done and bring in the results. She recommended a lab, said I should request the Anti-Aging Workup. I’m liking the sound of this already. I go to the lab, the clerk prints up the Anti-Aging Workup with prices, tells me not to eat for 12 hours before the test and she’ll see me in the morning.

This is all in Spanish, by the way. Oh yeah, I’m practically fluent. Ok, not quite. Actually, when I know the topic, if I can catch a couple of words in the sentences coming at me, I can usually work it out.

It’s not until you are finally comfortable going into any store, vet, bank, wherever, that you realize just how intimidated you used to be by not knowing the language. There were days in the beginning when we didn’t even leave the house because it was all just too hard. We couldn’t ask directions. We couldn’t read the signs. We’d get into a store and realize we didn’t know the word for fingernail clippers…

But not now. Cortauñas (fingernail clippers in Spanish). Now it’s fun: I know I’ll eventually be understood. Or not. If I get lost, I’ll find my way back. If all else fails, I can call Ryan who IS practically fluent and he tells me what to say in his beautiful tico accent. But, today, so far, I’m doing good here in the lab…

So good, I can understand the price. I almost faint. HA. Seems I’ve stumbled onto the area of Costa Rica medical care that is not that cheap. The 20 different anti-aging tests I need cost a whopping $450. Wow. I’m so old I need expensive blood tests. Like:

TGO Y TGP (something about uric acid and the liver, could not find a compatible link in English)

I thought $450 was a bit much so I spent a week going to four different labs, comparing prices. The first one, Laboratorios Labin, was the $450. The second was a tiny little lab in the village of old Escazú. Very unassuming, not that clean-looking, totally NOT impressive at all. But cheap: $300 and if I paid cash, I’d get a 15% discount. A friend of mine uses this lab and swears by them, but they couldn’t do the IGF-1… I’m sorta relieved.

NOTE: Always ask for a discount for cash. You’ll always get 5% and most often 10%. Always ask. Even my dentist gives it.

Clinica Biblica was the most expensive at $512 – I thought they’d be less. I settled on Echandi Labs for $400 with a 10% discount on top of that, so $360. They are a chain, very modern office, efficient, knowledgeable, came highly recommended. I went this morning, will get the results Monday, see la doctora Tuesday ($50), all fixed up by Wednesday night, sane for Thanksgiving. The boys will be grateful.

I’d like to know how much this blood work-up costs in the states so I can either gloat or cry. But it’s not that easy to find out. In the states you don’t just walk into a lab and say "How much to measure my estrogen?" They’ll need to see a prescription first, and you don’t get to see the results. Oh no. Those are private and complicated.

Here, you get all the test results and you are actually trusted to take them to your doctor. Or not. We have a whole stack of x-ray film and photos of our colons with our fingerprints all over them. In fact, I can call any lab or doctor and have any test I want. Just for fun. I could waltz in tomorrow to CIMA Hospital and have an MRI for $400. I won’t… I’ve already spent my $400 this week (blood tests and some bagels). But I could. Thatsa nice.

14 Comments

Paul M.
on November 17, 2007 at 8:26 am

Hola Sally,
I looked up some of those terms in your blog entry and was thinking that TGO & TGP might have been the same as a liver function test but it’s apparently not. (BTW, my aunt, a RN always used to advise me to get a liver function test every so often.)
The spanish text with all the unfamiliar vocabulary threw me almost immediately with the word ‘suero’, which I thought I knew but needed to be sure to continue reading, so I went online looking for a spanish dictionary. Amongst the results that popped up was an on-line version of the Royal Spanish Academy’s dictionary.
Anyway in my opinion, it’s the final word on spanish vocabulary and it’s at
Real Academia Españolahttp://www.rae.es/
It is a spanish/spanish dictionary but don’t let that throw you. By looking up words and having the definitions given in their own vernacular it is amazing just how much more one learns doing it that way.
This is really the spanish dictionary to end all spanish dictionaries since the Royal Spanish Academy is responsible for documenting the spanish language so they are the ‘non plus extra’, i.e., the definitive source for looking up words in the language.
I found a CR-rom copy of it for about $120 in Libreria Lehmann about five years ago. It is a wonderful language tool and looking up stuff on my comuter using it ‘es una ganga’ (=it’s a snap). And if you don’t understand a word in a definition you can just click on it and you will be instantly taken to that word.
The CD-rom version is more manageable in many ways since the print copy comprises 22 volumes side-by-side on your shelf. And, just FYI, CR-roms don’t mildew! It’s also one tool that won’t rust, either. [ G ]
¡Puras Palabras!
Paul
==

Don’t feel bad about the price. Once my daughter paid $750 for blood work for her CAT in Atlanta. Since it was me who picked the cat from the vet and was paying the bill (with her credit card, but still) I almost fainted, wondered for a moment whether the vets to the stars in Hollywood charged so outrageously for their services, then took the cat from her and switched the vet to mine!

Last time Bella was a little sick and we took her to her pediatrician in Escazu – he wanted to do a culture, urine test and blood test. He called “his guy” – who came TO THE OFFICE in about 20 minutes. Took the samples, we paid him ($40), he left and 20 minutes later he reported results back to the Doctor (while we waited) so the Doctor could prescribe the right medicine. This time he wrote it out and we took it to the pharmacy, but last visit he called it in and the pharmacy delivered to the doctor’s office. (Mainly because he wanted to teach us how to administer the asthma med to the baby – like we didn’t already know That routine). Gus was also examined and medicated for pink eye. This visit cost us $60.
So in the same 60 minutes we would have spent at our pediatrician in the States (who I loved and miss for his thouroughness and greatness), but still – in same 60 minutes, we are seen, tested, and medicated – that would have been 4 hours in states, easy.
We didn’t get to check prices, shop around, but the convienience factor was OUTSTANDING!
By the way – doesn’t Ryan take Advair? If so, what pharmacy do you go to for it? I checked the Fischel’s in Spoons and they didn’t have it.
Thanks,
Jen

Hey Paul – thanks for the link. Hal loves his Spanish dictionary for that very reason: if you look it up in the language and can get thru the actual definition, you learn WAY more. He will love this site. I learn thru osmosis…
Minerva, yeah, $750 for a CAT. I feel better about it. I’m sure this would be way more expensive in the states, almost no question. The price tag threw me at first.
Yes, Jen, the whole doctor experience here is so much less stressful in time and money. And the care, I’ve always felt, has been at least as good and often better.
Ryan doesn’t take Advair, it got some pretty bad press a while ago which is maybe why you don’t see it here? He had just been prescribed it in the states and then the bad press, a couple of years ago. I have no idea if the bad press was valid or not… He takes Singulair (the anti allergy pill – most people believe bad asthma attacks are brought on by air borne allergies) and Symbicort which is the inhaler (instead of Advair). Amazing how little info is out there on asthma!!!

Hi Sally! This is the first time I am writing and was given your name by Dara Bortman. (I met her at a workshop I gave recently at her synagogue)
I am considering bringing my boys to Costa Rica for the next school year…they will be 14 and 16 then (9th and 11th grade). I have been checking out the schools (found that area of your site very helpful with the list of schools). We spent a month this past summer at Finca la Flor de Paraiso and had a wonderful time. Volunteered, took some spanish immersion classes, and also travelled around a bit.
Do you have any comments especially on any of the schools? it seems like the European and Lincoln schools are good, and I was intrigued by the Monteverde Friends School but I’m wondering if that is too far in the middle of nowhere. I would love to hear your thoughts. and if any other readers have suggestions to share as well…
Also as I read your message above about your son’s asthma I wondered if there are any good chiropractors around where you are and if so if you have had him under care? I am a chiropractor and the children I see with asthma often display many less sypmtoms over time and can lessen their meds….If we make it there next year I’ll be happy to check him if you like!
There are many logistics to handle to make this trip happen for us but I think it would be a great experience for both myself and my kids – do you agree from your perspective?
Thanks! Susan

Hi Susan,
Well, any friend of Dara’s…. I adore the Bortmans – we miss them terribly!
I think bringing your boys to Costa Rica for a year (at least) will be most excellent, even if they didn’t go to any school at all. Quite an education.
My boys went to European School and we loved it, but we are big on math and the E.S. is not. Both it and Lincoln get the highest marks; they are really the only two at the moment I would consider. I don’t think you can go wrong, especially just for a year.
Monteverde is OUT THERE. And the road to get there is hideous, so any traveling you do will be difficult. If I were only coming for a year, I would stay around the central valley – it’s a great jumping off place and, while it’s still a developing nation, you will have the most services here of anywhere.
I have never had Ryan see a chiropractor, but I have heard it is a good idea. I would love to do anything to lessen his meds!!! He does amazingly well when the sugar and white flour products are not so available, but they are teenagers and keeping them off the junk food is almost impossible. Make that impossible, unless I’m going to be a vigilante. I would love to have you check him out. If I can find a good chiropractor here, I will take him in. Finding a good one is the trick.
Keep me posted on your plans – YES it is a good idea. There is literally nothing to lose. I will look forward to meeting you all when you come. See you!

Hi –
You said this: Ryan doesn’t take Advair, it got some pretty bad press a while ago which is maybe why you don’t see it here? He had just been prescribed it in the states and then the bad press, a couple of years ago. I have no idea if the bad press was valid or not…
I take Advair (seratide here) 250/50. I don’t recall any bad press – fill me in? I buy it here for 60.00 (220.00 in the US, 41.00 in Mexico). I’ve never had any problems with it, and in fact can’t breathe without it. However, I’m also always open to alternatives. I don’t have asthma, I have emphysema (the politically correct term is “COPD” which includes forms of asthma, but I think that “softening” the term “emphysema” is just plain misleading), so have found the use of inhaled steroids works best.
Would like to know what the bad press was, in case I should look harder for an alternative.
Thanks!

Hi DJ, I google searched “advair bad press” and got lots of hits:http://www.google.com/search?num=100&hl=en&newwindow=1&q=advair+bad+press&btnG=Search
I don’t even know if what they were saying about it – specifically what I read was that Advair prevented most asthmatic episodes BUT that if you had one, that one was more severe… – I don’t know if that is even true! It may have been successfully refuted. Shows the power of the press… let me know what you find out, ok?

Thanks for this info Sally. I’m planning to make an appointment to see your doctor, although the prices of these tests pretty much freak me out. I’m wondering what prices you’ve found for any medications she has prescribed. Thanks for any information you can provide on this.
Laurie

Hi Laurie,
The only thing Dra. Ortuño has prescribed for me is the hormones. I was on one cream that cost 37,000 about every month and a half. Now I have a new prescription: a cream for 23,000 and then the progesterone in a suppository, 30 days supply for 9,000 so pretty much the same cost.
The creams and/or suppository is better than an oral pill. Oral pills are hard on the liver.
I’m very happy with being on bio-identical hormones. Much better than the chemical stuff which I tried first, hated how I felt and how the pregnant horses must have felt!!!
See you!

Hello,
I live in Cahuita, Costa Rica for 15 years now. Have small hotel. Anyways, have heard and read much about bio identical hormones, and did not think I could find this in Costa Rica,however after some surfing I found you here. Do you have a doctor who knows about and works with bio identical hormones, if so I would appreciate his name and address, as well as where you buy your bio identical hormones. Thanks for any info, you might have on this!

Hi Terry,
I have two doctors that can prescribe bio-identical hormones: Dr. Castro and Dra. Ortuno.
My husband and I are wild about Dr. Paulo Castro 2234-1402, drpcastro@vitalitycr.com (in San Pedro). He’s into natural healing, vitamin and hormonal therapy, anti-aging specialist (“anti-aging from the inside out” as he puts it), supplementation, more natural forms of healing the body, big Linus Pauling fan, very smart, trained in the U.S. Speaks English. He is now our doctor of choice.
My first gyn here was Dra. Livia Ortuño Pinto tel: 2221-5872. She has an office next to Clinica Biblica and one in Escazú (Escazú is only for consultation, for exams you have to go to the CB office.) Call between 8a and noon to get an appointment (that’s when her secretary is in). Sect’y only speaks Spanish, Dra. Ortuño speaks perfect English. She is an excellent doctor, we are just more in tune with Dr. Castro’s approach to holistic living.
If you are interested in bio-identical hormone replacement, both of these doctors can do that for you.
The pharmacy is Premafarma and Dra. Ana Violeta Ovares, 2225-3774. She is great, speaks English, studied in the U.S., can do anything. premafarma@ice.co.cr, http://www.premafarma.com